Psychedelic Therapy's Transdiagnostic Effects: A Research Domain Criteria (RDoC) Perspective
Frontiers in Psychiatry – December 17, 2021
Source: OpenAlex
Summary
Psychedelic therapy, combining psychopharmacology and psychotherapist support, shows promising potential for over seven diverse mental health challenges like depression and anxiety. This approach targets maladaptive patterns in emotion and cognition. Understanding how these substances, through their chemical influence on neurotransmitter receptors, impact behavior is crucial. Using the Research Domain Criteria (RDoC) framework from clinical psychology, accumulating evidence explores three multimodal mechanisms from molecular to network levels, aiming for precise, personalized psychedelic treatments.
Abstract
Accumulating clinical evidence shows that psychedelic therapy, by synergistically combining psychopharmacology and psychological support, offers a promising transdiagnostic treatment strategy for a range of disorders with restricted and/or maladaptive habitual patterns of emotion, cognition and behavior, notably, depression (MDD), treatment resistant depression (TRD) and addiction disorders, but perhaps also anxiety disorders, obsessive-compulsive disorder (OCD), Post-Traumatic Stress Disorder (PTSD) and eating disorders. Despite the emergent transdiagnostic evidence, the specific clinical dimensions that psychedelics are efficacious for, and associated underlying neurobiological pathways, remain to be well-characterized. To this end, this review focuses on pre-clinical and clinical evidence of the acute and sustained therapeutic potential of psychedelic therapy in the context of a transdiagnostic dimensional systems framework. Focusing on the Research Domain Criteria (RDoC) as a template, we will describe the multimodal mechanisms underlying the transdiagnostic therapeutic effects of psychedelic therapy, traversing molecular, cellular and network levels. These levels will be mapped to the RDoC constructs of negative and positive valence systems, arousal regulation, social processing, cognitive and sensorimotor systems. In summarizing this literature and framing it transdiagnostically, we hope we can assist the field in moving toward a mechanistic understanding of how psychedelics work for patients and eventually toward a precise-personalized psychedelic therapy paradigm.